Brock-led team seeking South Asian participants for colon cancer screening research

Although regular screening for colon cancer is highly recommended for adults 50 years and older, a Brock nursing expert says screening rates are particularly low for South Asian immigrants.

“When people from the Indian sub-continent first come to Canada, their risks of colon cancer are not the same as Canadians for colorectal cancer,” says Associate Professor of Nursing Joanne Crawford. “But with time spent in Canada, their risk for this type of cancer increases and approaches the same risk as Canadian-born individuals.”

Crawford is leading a team of researchers from Brock, York and McMaster Universities to investigate the barriers that may be holding older South Asian immigrants back from seeking, and receiving, this type of cancer test.

The team is doing this through 20-minute in-person, telephone or videoconference interviews in English or Urdu with healthy individuals of South Asian descent who are originally from the Indian subcontinent. The survey seeks to find out participants’ screening choices as well as their knowledge, beliefs and attitudes about colorectal cancer screening. Those participating need to reside in the Greater Toronto Area (GTA), be 50 to 74 years of age and be at average, not high, risk of colon cancer.

The current research is a follow-up to an earlier pilot study in Hamilton and Brampton. The team is conducting the research in the GTA because of the higher density of South Asians in specific communities, says Crawford.

Crawford first became interested in the issue of access to population-based screening while working as a public health nurse prior to joining Brock. She was a member of a chronic disease prevention team planning community outreach health programs with various immigrant communities.

She says she noticed people originating from South Asia who settled in the Hamilton community had less knowledge and awareness of colon cancer prevention compared to people coming from other areas of the world.

“If people have lower rates of screening, they will not benefit from finding pre-cancer or early cancer and are more likely to present with symptoms later, when their cancer is more advanced,” she says.

In the pilot study, the team found that the length of time participants lived in Canada and their ability to speak English didn’t make a difference in screening rates.

“Those who had been in Canada for 30 years still had not had the test even if they had higher knowledge and understanding,” says Crawford. “In fact, it may have been that new residents may have taken the test because their doctor told them to do so.”

The current survey was developed in consultation with community members and South Asian residents, she says. Urdu was chosen as another language to enable greater access as it is understood across other language groups in the spoken form, such as Punjabi or Bangladeshi, she says.

People interested in being interviewed can reach the team by emailing Zahid Iqbal Sahi at, calling 437-238-3568 or visiting Crawford’s faculty page.

More details, including a video explanation in the Urdu language, can be found on this faculty page or the Toronto South Asian Colorectal cancer screening project’s Facebook page.

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